Science —

Same-sex marriage linked to decline in teen suicides

States that legalized gay marriage early created a natural experiment.

A recent study published in JAMA Pediatrics suggests that the legalization of same-sex marriage is associated with a reduction in the proportion of high school students who reported making a suicide attempt. This study indicates that governmental policies regarding non-normative sexuality may have an influence on mental health outcomes for adolescents.

The study used data from the state-level Youth Risk Behavior Surveillance System, which tracks dangerous and risky behaviors exhibited by teenagers. Its authors used data from forty-seven states, including thirty-two states that implemented same-sex marriage policies between 2004-2015. They looked at suicide behaviors in the full population of high school students and then did a secondary analysis using the subset of students who self-identified as belonging to a sexual minority (gay, lesbian, bisexual, or unsure about their sexual identity).

One limitation of using this type of data is that it depends on self-reporting of suicide attempts, which is tricky because suicide attempts are typically under-reported. This approach also means that the researchers did not include any information about teens who died from their suicide attempts; it only captures teens who attempted suicide but survived. This methodological limitation may seem like a big one, but the proportion of suicide attempts that result in teen deaths is very small, so suicide attempts are a reasonable proxy for overall teen mental health.

The researchers used a “differences-in-differences” approach to analyze this data. This analysis allows researchers to use observational data about an intervention to approximate the effects that would be seen in a randomized controlled trial for the same intervention. In other words, this approach treats observational data as though that data came from a “natural experiment,” one with an intervention group (states that implemented same-sex marriage) and a control group (states that did not). This method looks at the difference in pre-intervention suicide attempts data and post-intervention suicide attempts data for these two groups, hence the name “difference-in-difference.”

The researchers quantified the difference in number of attempted suicides in states that passed laws legalizing same-sex marriage and states that did not pass those laws. Finally, they compared the difference in suicide attempts for the same two groups of states before same-sex-marriage legalization and after.

The comparison of these differences is important to ensure that changes in rates of suicide attempts are not associated with large-scale cultural changes. By tracking individual states, the researchers could identify local attitudes regarding sexual orientation. Still, the authors couldn’t control for individual-level differences, such as economic status or religious affiliation. These demographic characteristics could play an important role in determining the likelihood of a suicide attempt. Future studies that look more closely at individuals and their personal social context are needed.

Using differences-in-difference, the researchers saw that legalization of same-sex marriage was associated with a statistically significant decline in suicide attempts for all teens—a seven percent relative reduction in suicide attempts for adolescents of all sexual orientations. The association between same-sex marriage legalization and reduction in suicide attempts was also significant for teens who identified as sexual minorities. For this subgroup, there was a 14-percent relative reduction in suicide attempts after the passage of same-sex marriage laws.

Looking at the longitudinal suicide-attempt data, the authors saw that these reductions in suicide attempts persisted for up to two years after legalization of same-sex marriage. The persistence of this drop suggests that any backlash regarding same-sex marriage didn’t make things any harder on teens.

Latest Ars Video >

The Greatest Leap, Episode 3: Triumph

In honor of the 50th anniversary of the beginning of the Apollo Program, Ars Technica brings you an in depth look at the Apollo missions through the eyes of the participants.

The Greatest Leap, Episode 3: Triumph

The Greatest Leap, Episode 3: Triumph

In honor of the 50th anniversary of the beginning of the Apollo Program, Ars Technica brings you an in depth look at the Apollo missions through the eyes of the participants.

Roheeni Saxena
Roheeni is a Science Correspondent writing for Ars Technica. She holds an MPH from Columbia, where she worked as Associate Director of Educational Programs. She has also worked as a bench researcher for Harvard Medical School and the NIMH. She is currently pursuing a PhD in environmental health and neurotoxicology from Columbia. Emailroheeni.explains.science@gmail.com//Twitter@RoheeniSax